2027 ICD-10-CM Diagnosis Code J44.81Bronchiolitis obliterans and bronchiolitis obliterans syndrome

ICD-10-CM Codes›J00–J99›J40-J4B›J44

ICD-10-CM J44.81
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

J44.81 is a billable ICD-10-CM diagnosis code for bronchiolitis obliterans and bronchiolitis obliterans syndrome. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 190 through 192. Coders also document this condition as chronic bronchiolitis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Chronic obstructive pulmonary disease and bronchiectasis.

For Medicare Advantage risk adjustment, J44.81 maps to CMS-HCC Category 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders) under the V28 model, adding a risk factor of about 0.319 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
J44.81
Billable Status
Yes — Valid for Submission
Code Describes
Bronchiolitis obliterans and bronchiolitis obliterans syndrome
Short Description
Bronchiolitis obliterans and bronchiolitis obliterans synd
Parent Code
J44.8
Other specified chronic obstructive pulmonary disease

Code Classification

ChapterJ00–J99Diseases of the respiratory system
SectionJ40-J4BChronic lower respiratory diseases
CategoryJ44Other chronic obstructive pulmonary disease
This CodeJ44.81Bronchiolitis obliterans and bronchiolitis obliterans syndrome

Medicare Risk Adjustment (HCC)Billing

J44.81 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 280— Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
Payment HCC · PY 2027 one of 79 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.319
community, non-dual, aged · ranges 0.209–0.390 across segments
Hierarchy
Superseded by HCC 276, HCC 277, HCC 278, and HCC 279
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 111
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 111 · ESRD (V21): HCC 111 · ESRD (V24): HCC 111
ESRD V21 weights: 0.072 dialysis, 0.299–0.313 functioning graft · ESRD V24 weights: 0.058 dialysis, 0.187–0.344 functioning graft
Part D (RxHCC)
RxHCC 229 — Chronic Obstructive Pulmonary Disease, Bronchiectasis, and Other Asthma
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Chronic bronchiolitis
  • Chronic obliterative bronchiolitis
  • Obliterative bronchiolitis
  • Obliterative bronchiolitis due to infectious disease

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to J44.81: its own notes plus those printed at J44, block J40-J4B, and Chapter 10. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From J44 Other chronic obstructive pulmonary disease applies to 5 codes
  • asthma with chronic obstructive pulmonary disease
  • chronic asthmatic (obstructive) bronchitis
  • chronic bronchitis with airway obstruction
  • chronic bronchitis with emphysema
  • chronic emphysematous bronchitis
  • chronic obstructive asthma
  • chronic obstructive bronchitis
  • chronic obstructive tracheobronchitis

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Obliterative bronchiolitis

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Block J40-J4B Chronic lower respiratory diseases applies to 40 codes
  • bronchitis due to chemicals, gases, fumes and vapors (J68.0)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From J44 Other chronic obstructive pulmonary disease applies to 5 codes
  • bronchiectasis (J47.-)
  • chronic bronchitis NOS (J42)
  • chronic simple and mucopurulent bronchitis (J41.-)
  • chronic tracheitis (J42)
  • chronic tracheobronchitis (J42)
  • emphysema without chronic bronchitis (J43.-)
From Block J40-J4B Chronic lower respiratory diseases applies to 40 codes
From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • smoke inhalation (T59.81-)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Code First

The underlying condition named in the note is sequenced before this code.

  • if applicable:
  • complication of bone marrow transplant (T86.09)
  • complication of stem cell transplant (T86.5)
  • heart-lung transplant rejection (T86.31)
  • lung transplant rejection (T86.810)
  • other complications of heart-lung transplant (T86.39)
  • other complications of lung transplant (T86.818)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • code, where applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

On J44.81 itself
  • if applicable, associated conditions, such as:
  • chronic graft-versus-host disease (D89.811)
  • chronic lung allograft dysfunction (J4A.-)
  • chronic respiratory conditions due to chemicals, gases, fumes and vapors (J68.4)
From J44 Other chronic obstructive pulmonary disease applies to 5 codes
  • type of asthma, if applicable (J45.-)

Notes

General instructions on how these codes are used.

From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name J44.81, its category, or a range that includes it.

Applicable To 1

These notes mention J44.81.

  • Z82.5 Family history of asthma and other chronic lower respiratory diseases
    Conditions classifiable to J40-J47 names J40-J47, which includes this code

Excludes1 4

These codes carry an Excludes1 note naming J44.81: they are not reported together with it, unless the two conditions are unrelated.

  • J42 Unspecified chronic bronchitis
    bronchiolitis obliterans and bronchiolitis obliterans syndrome (J44.81)
  • J42 Unspecified chronic bronchitis
    chronic asthmatic bronchitis (J44.-) names J44.-, which includes this code
  • J42 Unspecified chronic bronchitis
    chronic bronchitis with airways obstruction (J44.-) names J44.-, which includes this code
  • J42 Unspecified chronic bronchitis
    chronic emphysematous bronchitis (J44.-) names J44.-, which includes this code

Excludes2 5

These codes carry an Excludes2 note naming J44.81: its condition is not part of those codes, and both may be reported when the patient has both.

  • J20 Acute bronchitis
    chronic obstructive bronchitis (J44.-) names J44.-, which includes this code
  • J20 Acute bronchitis
    chronic obstructive tracheobronchitis (J44.-) names J44.-, which includes this code
  • J41 Simple and mucopurulent chronic bronchitis
    chronic obstructive bronchitis (J44.-) names J44.-, which includes this code
  • J43 Emphysema
    emphysema with chronic (obstructive) bronchitis (J44.-) names J44.-, which includes this code
  • J43 Emphysema
    emphysematous (obstructive) bronchitis (J44.-) names J44.-, which includes this code

Code First 1

These codes say to code first a condition named in the note, and J44.81 is one of the conditions named.

  • I21.A1 Myocardial infarction type 2
    chronic obstructive pulmonary disease (J44.-) names J44.-, which includes this code

Code Also 3

These codes say J44.81 may also be needed to fully describe the condition. The note gives no sequencing direction.

  • J4A Chronic lung allograft dysfunction
    if applicable, bronchiolitis obliterans syndrome (J44.81)
  • J4A.0 Restrictive allograft syndrome
    if applicable, for mixed chronic lung allograft dysfunction, bronchiolitis obliterans syndrome (J44.81)
  • J68.4 Chronic respiratory conditions due to chemicals, gases, fumes and vapors
    obliterative bronchiolitis (J44.81)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR RSP008
Chronic obstructive pulmonary disease and bronchiectasis
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Bronchial Disorders

When you breathe in, the air travels down through your trachea (windpipe). It then goes through two tubes to your lungs. These tubes are your bronchi. Bronchial disorders can make it hard for you to breathe.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Code History & ChangesHistory

Replacement J44.81 replaces the following previously assigned code(s):

  • J42 - Unspecified chronic bronchitis
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About J44.81Overview

What is the ICD-10 code for bronchiolitis obliterans and bronchiolitis obliterans syndrome?

The ICD-10-CM code for bronchiolitis obliterans and bronchiolitis obliterans syndrome is J44.81 (sometimes written as J4481). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is J44.81 (Other specified chronic obstructive pulmonary disease) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report bronchiolitis obliterans and bronchiolitis obliterans syndrome on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does J44.81 group to?

When bronchiolitis obliterans and bronchiolitis obliterans syndrome is the principal diagnosis on an inpatient stay, it groups to MS-DRG 192, 190, 191, with relative weights from 0.6285 to 1.0749 depending on complications. Higher weights mean higher Medicare reimbursement.

Can J44.81 be reported with J68.0?

Not as a rule. The Excludes1 note at block J40-J4B, which applies to J44.81, lists "bronchitis due to chemicals, gases, fumes and vapors (J68.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What is coded first with J44.81?

The Code First note reads: , if applicable: complication of bone marrow transplant (T86.09); complication of stem cell transplant (T86.5); heart-lung transplant rejection (T86.31); lung transplant rejection (T86.810); other complications of heart-lung transplant (T86.39); and 1 more listed in the Instructional Notes section. When one of these applies, it is sequenced before J44.81.

What HCC is J44.81?

J44.81 (bronchiolitis obliterans and bronchiolitis obliterans syndrome) maps to CMS-HCC Category 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders), commonly written as HCC 280, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 111 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 229.

Does J44.81 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, J44.81 adds a risk adjustment factor of about 0.319 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.209 to 0.390 depending on the payment segment). A more severe related category (HCC 276, HCC 277, HCC 278, and HCC 279) supersedes it when both are reported. See the full factor table on the HCC 280 category page.